Five Distinct Challenges Of Meaningful Use Stage 2

Posted on by Frank J. Rosello

As healthcare providers and organizations carefully review the Meaningful Use Stage 2 requirements, they will notice a number of changes, tighter requirements and higher percentages to hit.  Paying very close attention to the numerous changes in Stage 2 as this may impact whether or not eligible providers and hospitals qualify to receive their entire incentive payments.

Here are five distinct challenging developments providers will need to pay close attention to as they move to Meaningful Use Stage 2:

1. Structured lab results. A lab interface makes the labor involved in managing lab results notably less. Look out for a lab interface when trying to achieve Stage 2. Whereas normal lab results come back as a fax or PDF, implementing an interface means that the report feeds back in to the provider’s EHR as structured data. Lab tests are a critical element of patient documentation, which itself is a major factor in attesting to Stage 2 as well as efficiently filing claims and receiving reimbursement. To attest to Stage 2, providers will need to increase their use of structured data in lab results to 55 percent.

2. Ongoing submission to registries. While registries were addressed in Stage 1, fully implementing a health information exchange connection is addressed in Stage 2. It is important to note that not all providers have the tools built in to their EHR software to submit documents to registries, and that many states do not even have the required registries in place. There’s a notable discrepancy between requirements and what’s available in technology today and there are a lot of requirements for Stage 2 that are a lot more demanding for vendors.  There is a real possibility that a lot of the smaller EHR vendors are not going to be able to keep up with all of the changes required with Stage 2. This is something that providers, who have already attested to Stage 1, should immediately engage their EHR vendor about especially if they went the inexpensive web native  / SaaS model route.

3. Patient access to health information. In order to attest to Stage 2, providers must provide an electronic portal for health information to their patients. Five percent of their patients must have accessed the portal, raising concerns with doctors who say they have no control of patient behavior outside of the office, or who have elderly or low-income patients who may not have access to the internet. Additionally, there are “certain information control issues” around patient access to their health information.  For example, as a child or an adolescent grows up, at what point should their parent no longer have access to their portal?

4. Summary of care referrals. When a doctor refers a patient to a specialist or another doctor, they must send along their notes describing the patient’s condition and what the specialist should look out for. Although one or both providers may use an EHR, most systems are not linked well enough to facilitate easy transfer of data. As a result, care referrals are often still facilitated via a printed form. If a summary of care is only recorded on paper, then someone has to sit down and enter all these things manually however,  it could be transmitted in a structured way electronically. Stage 2 begins to streamline the process for transmitting these documents electronically; the rules currently requires that 10 percent of a practice’s summaries be transmitted in an electronic fashion.

4. Computerized provider order entry (CPOE). A critical part of a full-flight EHR, CPOE fell under some rules during Stage 1, and those requirements have aggressively increased. In Stage 2, healthcare providers are now required to have 60 percent of their prescriptions go through CPOE, in addition to 30 percent of their labs and diagnostic images. It’s important to have an interface for not only lab results but diagnostic images as well. CPOE, when implemented properly, can increase efficiency and reduce mistakes.

Frank J. Rosello

is CEO & Co-Founder of Environmental Intelligence LLC.

Environmental Intelligence, LLC, is a complete, full-service healthcare IT solution provider. With a team having more than 10 years of proven clinical expertise in delivering end-to-end health IT solutions, Environmental Intelligence provides medical practices and facilities onsite expert IT consulting, installation, and implementation that is focused on physicians, their patients, and the quality of their care.

Contact us to learn more about our Physician Focused – Patient Driven® approach to Health IT.


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